Neuroblastoma: Symptoms, stages, treatment, and more

Neuroblastoma is the third most common childhood cancer after leukemia and cancer of the central nervous system. Neuroblastoma is an embryonal tumor of the sympathetic nervous system. Usually, as a fetus matures and after birth, the neuroblasts develop normally. But the abnormal growth of nerve cells leads to this disease.

Neuroblastoma Definition

Neuroblastoma is cancer that develops from specialized nerve cells (neuroblasts) and mostly affects babies and young children. It commonly occurs in 1 of the adrenal glands and affects children age 5 or younger. Some forms of neuroblastoma go away on their own, while others may require multiple treatments.

Neuroblastoma can also begin in or spread to the spinal cord in the neck, chest, tummy, or pelvis. It can spread to other organs such as the bone marrow, bone, lymph nodes, liver, and skin. Generally, neuroblastoma does not run in families.

What type of cancer is neuroblastoma?

How does neuroblastoma start? Neuroblastoma is a rare type of cancer that develops from immature nerve cells in the fetus called neuroblasts. This most commonly arises in and around the adrenal glands, situated above the kidneys. Neuroblastoma can also develop in other areas of the abdomen and near the spine. Cancer cells form in the nerve tissue of the adrenal gland, neck, chest, or spinal cord.

What does a neuroblastoma tumor look like?

Signs and symptoms of neuroblastoma vary depending on where the cancer is and whether it’s spread. The symptoms can be vague and tough to spot and can be mistaken for those of more common childhood conditions. Signs and symptoms of neuroblastoma include:

  1. Fever
  2. Back pain
  3. Wheezing
  4. Abdominal pain
  5. Unexplained weight loss
  6. Fatigue, loss of energy, pale skin
  7. Difficulty in swallowing and peeing
  8. Chest pain and bruising in the skin
  9. Difficulty in breathing (if the cancer is in the chest)
  10. Proptosis (Eyeballs seem to protrude from the sockets)
  11. Bulging eyes, jerky eyes, and muscle movements
  12. Dark circles similar to bruises, around the eyes (“black eyes”)
  13. Changes to the eyes, including drooping eyelids, unequal pupil size
  14. A limp and general irritability, bone pain, or soreness
  15. Changes in bowel habits, such as diarrhea or constipation
  16. Paralysis (inability to move a body part), numbness in the lower body
  17. Painless, bluish lump or mass in the skin that isn’t tender when touched
  18. Lumps of tissue in the abdomen, neck, or chest, particularly around the eyes
  19. Swollen, pain in the abdomen, and decreased appetite (if the tumor is in the abdomen)
  20. Weakness in the legs, unsteady walk, difficulty walking (if cancer presses on the spinal cord)
  21. If the tumor is in the neck then symptoms of sweating, and red skin occur which are the signs of nerve damage in the neck

Less common signs and symptoms of neuroblastoma

  1. Fever
  2. Feeling tired
  3. Easy bruising or bleeding
  4. High blood pressure
  5. Horner syndrome
  6. Shortness of breath
  7. Jerky muscle movements
  8. Severe watery diarrhea
  9. Uncontrolled eye movements
  10. Petechiae (flat, pinpoint spots under the skin caused by bleeding)

In how many ways does cancer spread to the body?

There are three ways that cancer spreads in the body that are:

  • (1) Tissues: Cancer spreads from where it began by growing into nearby areas.
  • (2) Lymph system: Cancer spreads from where it began by getting into the lymphatic system. Cancer travels through the lymph vessels to other distant parts of the human body.
  • (3) Blood: Cancer travels through the blood vessels to other parts of the body.  It spreads from where it began by getting into the blood.

Where does neuroblastoma develop?

Neuroblastoma can also develop anywhere along the sympathetic nervous system chain from the neck to the pelvis. Most commonly, it develops in the adrenal glands. This occurs in 40 percent of localized tumors and 60 percent of cases of widespread disease.

What are the causes of neuroblastoma?

It is not clear what causes the initial genetic mutation that leads to neuroblastoma. In most cases of neuroblastoma, a cause is never identified. Neuroblasts are immature nerve cells that a fetus makes as part of its development process. Neuroblasts turn into nerve cells and fibers and the cells that make up the adrenal glands. Most neuroblasts mature by birth. In most cases, these neuroblasts mature or disappear. Others, however, form a tumor known as neuroblastoma.

Is neuroblastoma cancer curable?

  1. Some tumors can be cured easily while some pose an aggressive behavior.
  2. High-risk neuroblastoma patients are treated with intensive therapy.
  3. It is very difficult to cure relapsed high-risk neuroblastoma. For some patients, it can be managed as a chronic disease.
  4. The majority of tumors are very aggressive. So tumors are treated according to their aggressiveness.

Neuroblastoma Prognosis

Neuroblastoma is a cancer of the nerves outside the brain. About 90% of cases occur in children under age 10. The majority of children with aggressive tumors can’t be cured and will die from their disease.

Neuroblastoma is a deadly type of cancer and it accounts for 12 percent of childhood cancer deaths. But like all childhood cancers, neuroblastoma is a sporadic disease. There are just 700-800 cases annually in the USA.

What is the survival rate for neuroblastoma?

The 5 Year survival rates of neuroblastoma:

  1. The 5-year survival rate tells you what percent of children live at least 5 years after the cancer is found. Percent means how many out of 100. Neuroblastoma is also one of the few types of cancer for which survival differs significantly between the two sexes. Boys have a worse outlook than girls.
  2. In the case of high-risk neuroblastoma, the the-5-year survival rate is around 40% to 50%.
  3. With intermediate-risk neuroblastoma, the 5-year survival rate is between 90% and 95%.
  4. The 5-year survival rate is higher than 95% for children with low-risk neuroblastoma.
  5. Neuroblastoma has 5 years survival rates of only 67% which make it one of the lowest survival rates of all childhood cancers. A child’s survival rate depends on many factors, particularly the risk grouping of the tumor.

Is neuroblastoma genetic?

  • Does neuroblastoma run in families? Somatic mutations are present only in certain cells and are not inherited. When the mutation associated with neuroblastoma is inherited, the condition is called familial neuroblastoma.
  • It mainly affects children before the age of 5 years and rarely occurs in adults.
  • Neuroblastoma most often occurs in children who have no family history of the disease. Such type is known as sporadic neuroblastoma.
  • ALK and PHOX2B gene mutations give rise to the risk of developing sporadic and familial neuroblastoma.

At what age does neuroblastoma occur?

In the USA, about 800 new cases of neuroblastoma are diagnosed each year. The average age of a child diagnosed with neuroblastoma is about 1 to 2 years. It is found slightly more often in boys than in girls. This disease is rare in people over the age of 10 years. The disease is occasionally seen in teenagers or even young adults. Nearly 90% of cases are diagnosed by age 5. This cancer is detected by ultrasound even before birth.

Why do children get neuroblastoma?

  1. Can a baby be born with neuroblastoma? What is neuroblastoma in a child? The most common cancer in newborns is neuroblastoma. Usually, it is unusual for babies to be born with cancer.
  2. Neuroblastoma most commonly occurs in one of the adrenal glands situated above the kidneys, or in the nerve tissue that runs alongside the spinal cord in the neck, chest, tummy, or pelvis. Neuroblastoma is a rare type of cancer that mostly affects babies and young children.
  3. Neuroblastoma happens when neuroblasts instead of developing into nerve cells, grow and divide unchecked. A defect in the genes of a neuroblast allows it to divide uncontrollably.

Major Risk Factors for Neuroblastoma

  1. Boys are more likely to develop the disease.
  2. Most causes of neuroblastoma are diagnosed in children between the ages of one and two.
  3. 1% to 2% of neuroblastoma cases seem to result from a gene inherited from a parent.
  4. 90% of cases are diagnosed before the age of 5.
  5. Children with a family history of neuroblastoma may be more likely to develop the disease.

What are the complications of neuroblastoma?

Complications of neuroblastoma may include:

  1. Neuroblastoma cells may secrete certain chemicals that irritate other normal tissues.
  2. Neuroblastoma may cause a rare syndrome that causes abdominal swelling and diarrhea.
  3. Neuroblastoma may cause paraneoplastic syndrome that leads to rapid eye movements and difficulty with coordination.
  4. Neuroblastoma may metastasize to other parts of the body, including lymph nodes, bone marrow, skin, liver, and bones.
  5. Neuroblastoma tumors may grow and press on the spinal cord. This leads to the compression of the spinal cord. Spinal cord compression may cause severe pain and paralysis.

Can neuroblastoma go away on its own?

Some forms of neuroblastoma go away on their own, while others may require multiple treatments.

What are the chances of neuroblastoma coming back?

The probability of recurring decreases as more and more time passes after treatment is complete. In intermediate- or low-risk neuroblastoma, relapses occur in only 5-15% of cases. If it recurs, it comes back within the first two years after the end of treatment.

What is recurrent Neuroblastoma?

Recurrent neuroblastoma is cancer that has recurred after the treatment. Cancer may come back in the same place as a body or other parts.

Despite the name, neuroblastoma is not a brain tumor. Neuroblastoma is a type of childhood cancer that develops in nerve tissues outside of the central nervous system. Neuroblastoma cells arise from the adrenal medulla or paraspinal sites where sympathetic nervous system tissues are located. It usually begins in the adrenal gland on top of the kidney.

[Note: Copyright © 2013 Alan et al. The featured image is licensed under a Creative Commons Attribution 4.0 International License. The modified image is the derivative of “Significant abdominal distension with thin venous vessels on abdominal skin was noticed” used in a journal. The modified image is licensed under CC BY 4.0 by King.]

Does neuroblastoma show up on the x-ray?

Can a blood test detect neuroblastoma? Neuroblastoma cells are detected in the bone marrow. If neuroblastoma is suspected or has been found, your doctor will probably order several blood tests. Neuroblastoma cells make enough catecholamine chemicals that can be detected by blood or urine tests.

Can neuroblastoma spread to the brain?

  • Is neuroblastoma a brain cancer? The overall incidence of metastasis in the brain after treatment ranges from 1.7 to 11.7 percent.
  • It can be found anywhere along the spine. Relapsed neuroblastoma metastasizes to the CNS which may cause death.

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